Registration for: Birth and the Human Future 9am-5pm Friday August 15, 2014
Lost Valley Center, Dexter, Oregon
To Register:
Download or Copy this form and mail it with your check or money order to:
Birth and the Human Future, ℅ Marion Toepke McLean
38574 Dexter Rd., Dexter, Oregon, 97431
(Please make checks payable to: Marion Toepke McLean)
Name _______________________________________________________
E-mail _______________________________________________________
Phone # _____________________________________________________
Address ___________________________________________________________
____________________________________________________________
Payment: Conference and lunch
after July 15th $40.00
at the door $50.00
Dinner Thursday 8/14 $25
Breakfast Friday 8/15 $12
Breakfast Saturday 8/16 $12
Lunch Thurs or Sat $18
Full day 3 meals $55
Please note: Friday 8/15 dinner will be provided for no charge, contributions accepted.
Single Room at Lost Valley Center $45
Camping is available (fee by contribution) at site 10 minutes away
I have paid by check/money order (enclosed). _________
I have paid by pay pal. Here is my transaction confirmation #. ______________
OR:
Use the "Store" on this website and pay by credit card.
OR:
Copy and paste this form into an e-mail, complete the form and send to
[email protected].
Please note "workshop" in the subject line of your e-mail.
or use PayPal https://www.paypal.com/home
Refund for Workshop is available until August 1.
Camping will be available for donation at a site near Lost Valley.
Contact Marion at [email protected] if you want to come but can't afford it,
Specific dietary needs? Other questions or comments? Contact Marion at [email protected]
Lost Valley Center, Dexter, Oregon
To Register:
Download or Copy this form and mail it with your check or money order to:
Birth and the Human Future, ℅ Marion Toepke McLean
38574 Dexter Rd., Dexter, Oregon, 97431
(Please make checks payable to: Marion Toepke McLean)
Name _______________________________________________________
E-mail _______________________________________________________
Phone # _____________________________________________________
Address ___________________________________________________________
____________________________________________________________
Payment: Conference and lunch
after July 15th $40.00
at the door $50.00
Dinner Thursday 8/14 $25
Breakfast Friday 8/15 $12
Breakfast Saturday 8/16 $12
Lunch Thurs or Sat $18
Full day 3 meals $55
Please note: Friday 8/15 dinner will be provided for no charge, contributions accepted.
Single Room at Lost Valley Center $45
Camping is available (fee by contribution) at site 10 minutes away
I have paid by check/money order (enclosed). _________
I have paid by pay pal. Here is my transaction confirmation #. ______________
OR:
Use the "Store" on this website and pay by credit card.
OR:
Copy and paste this form into an e-mail, complete the form and send to
[email protected].
Please note "workshop" in the subject line of your e-mail.
or use PayPal https://www.paypal.com/home
Refund for Workshop is available until August 1.
Camping will be available for donation at a site near Lost Valley.
Contact Marion at [email protected] if you want to come but can't afford it,
Specific dietary needs? Other questions or comments? Contact Marion at [email protected]